Surveillance on Adverse Events Following COVISHIELD (ChAdOx1 nCoV-19) vaccination in Goa, India: An Observational Study.

BACKGROUND: COVISHIELD, ChAdOx1 nCoV- 19 Corona Virus Vaccine was granted emergency use authorization (EUA) as the first vaccine in India in January 2021. Knowing what to anticipate after vaccination will reduce vaccine hesitancy in the public. This study aimed to identify and measure the adverse events following COVID-19 vaccination. MATERIALS AND METHODS: A cross-sectional observational study was conducted at Goa Medical College, starting on February 21 till May 23, 2021. A total of 418 people were enrolled. We collected the data using the Microsoft Form and analyzed using Microsoft Excel and R-program. RESULTS: Of the 418 vaccine recipients, the incidence rate of AEFI (Adverse Events Following Immunization) was 54.31%. Fever, fatigue, and headache were the most commonly reported systemic AEFIs. Among these, 54.7% of AEFI were mild, 42.38% were of the moderate category, and only 2.96% were of grade 3 severity. None of the AEFIs were severe enough for hospitalization. Most of them developed symptoms within 24 hours of the first dose. Complete recovery from AEFIs took a median time of 24 hours. CONCLUSION: Most of our study findings were consistent with the phase 1, 2/3 trials findings of Oxford-AstraZeneca's ChAdOx1 vaccine. The AEFI symptoms were considered immune reactions to the vaccine. The AEFIs were more common among younger individuals and females. The chance of missing a serious adverse event like a thromboembolic phenomenon cannot be ruled out. We observed low AEFI rates with COVISHIELD in the Indian population compared to Oxford- AstraZeneca's ChAdOx1 vaccine in the UK-based population, which can be explained by preexisting immunity against adenovirus in the Indian population. However, based on the study findings, we may interpret that the COVISHIELD, Serum Institute of India, carries a good safety profile overall.

Prevalence of Dog Bite among Field Workers at a Primary Health Care Level in Goa.

This study was undertaken in 121 field workers in a primary health care set up in Goa to estimate the lifetime and annual incidence dog bite, and to assess their knowledge and practices regarding post-exposure prophylaxis. The annual and lifetime incidence of dog bite was 3.3% and 22.3%, respectively. Based on the comparable figures from studies in general population, Dog-bite seems to be an occupational hazard among these workers. Only 28.9% completed the full course of anti-rabies vaccine with its cost as the major reason for discontinuation. More than 90% consulted traditional healers and wound toilet was done by 70%. The overall knowledge and practices seemed better than those reported in other studies, but continued orientation of the field workers and access to free vaccination at the workplace is of paramount importance.

Concurrence of erectile dysfunction and coronary artery disease among patients undergoing coronary angiography at a tertiary Medical College Hospital in Goa.

The paper is based on the data from 92 males less than 45 years of age who underwent coronary angiography at Goa Medical College during the period July 2018 to February 2019. The objectives include to estimate the prevalence of erectile dysfunction (ED) and its risk factors, and to evaluate the pattern of coronary artery disease (CAD) among these patients. The ED prevalence was 46.2%. Diabetes, hypertension and alcohol intake showed significant association with ED; and these patients were almost three more likely to have a coronary blockade compared to those not reporting ED. This concurrence between ED and CAD makes a strong ground for routine inquiry in sexual history of young males with one or more cardiovascular risk factors.

Epidemiology of hospital acquired urinary tract infections in a medical college hospital in Goa.

BACKGROUND: Hospital Acquired Urinary Tract Infection (HAUTI) is the commonest among the nosocomial infections, and hospital specific data concerning its magnitude and attributes is essential to its effective control. MATERIALS AND METHODS: Prospective study was undertaken among 498 in-patients at the medical college hospital in Goa, employing the clinico-bacteriologic criteria of CDC, Atlanta, in the representative medicine and surgery wards. Antimicrobial sensitivity was tested using the Kirby-Bauer disc diffusion method. STATISTICAL ANALYSIS: Statistical significance of association was tested using the chi-square test and the unpaired t-test at 5% level of significance, while the strength of association was expressed as the Odd's ratio with 95% confidence interval calculated by Wolff's method. RESULTS: While the overall infection rate was 8.03/100 admissions, 33.6% of the catheterized patients developed HAUTI. Effect of gender was found to remain restricted to the development of HAUTI among females at an earlier age and earlier in time series compared to males, but no overall difference in incidence in the two sexes. The factors significantly associated with HAUTI included: duration of hospitalization, per urethral catheterization and the duration of catheterization. E. coli, Pseudomonas, Kebsiella, and Candida accounted for over 90% of the isolates, and 73.5% of these were resistant to all the antibiotics for which sensitivity was tested. The remaining isolates demonstrated sensitivity to amikacin and/or cefoperazone-sulbactam. CONCLUSION: High infection rate coupled with widespread isolation polyantimicrobial resistant nosocomial pathogens emphasizes the importance of meticulous surveillance of nosocomial infections in the hospital, with due attention to antibiotic prescription practices.

A prospective study of surgical site infections in a teaching hospital in Goa.

INTRODUCTION: Surgical Site Infections contribute significantly to increased health care costs in terms of prolonged hospital stay and lost work days. The problem was largely unexplored in an apex medical institute in Goa. AIMS AND OBJECTIVES: To estimate the incidence, and study the bacteriology and the factors associated with SSI in the study setting. SETTINGS AND DESIGN: Prospective study in the surgical wards of an apex medical teaching hospital in Goa. MATERIALS AND METHODS: Clinico-bacterilogical follow-up of 114 post-operative cases to the development of SSI, as per the CDC criteria (1991). Incidence was expressed as the infection rate per 100 operations. Antibiotic sensitivity testing was done using the disc diffusion method. STATISTICAL ANALYSIS: Association was tested by applying the Student t-test and the Chi-square test of significance, and the strength of association expressed as the Odd's Ratio. RESULTS: The overall SSI rate was estimated to be 30.7%; 5.4% for clean, 35.5% for clean-contaminated, and 77.8% for contaminated operations. Seventy-nine per cent of the isolates were gram-negative and almost 64% demonstrated polyantimicrobial resistance. CONCLUSIONS: The study emphasizes the need for the evidence-based infection control and antibiotic prescription policies in the hospital.